Chiropody

Lord Hunt of Kings Heath: To ask Her Majesty’s Government what level of commissioned podiatry places are proposed by Health Education England.

Earl Howe: Health Education England has commissioned higher education institutions to provide 365 new places for pre-registration podiatrists in the 2014-15 academic year.

Chiropody

Lord Hunt of Kings Heath: To ask Her Majesty’s Government what assessment they have made of the relationship between podiatry and better health outcomes, including for those with diabetes; and on what evidence that assessment is based.

Earl Howe: The Government recognises that podiatry is important for people’s physical and mental wellbeing. Regular foot care allows people to remain active and independent. It also offers alerts to early signs of other more serious health issues such as poor circulation and ulcers which is especially important for people who have diabetes.
	The National Institute for Health and Care Excellence (NICE) recommends that people with diabetes have regular examinations to assess individual risk, and those at increased risk are referred to a member of a foot protection team for long-term surveillance. In addition NICE recommends that all people with diabetes have their foot risk assessed on admission to hospital for any reason; and any person with diabetes who has newly occurring foot disease be referred for urgent assessment by a member of a specialist multidisciplinary team.
	The National Audit Office report The management of adult diabetes services in the NHS published in May 2012, confirms that foot care examination is one of the basic care processes for people with diabetes, to be delivered annually to provide early recognition and management of risk factors that can prevent or delay the development of ulcers which can lead to amputations.

Chiropody

Lord Hunt of Kings Heath: To ask Her Majesty’s Government what is their estimate of the cost to the National Health Service of poor foot care management.

Earl Howe: The National Audit Office report The management of adult diabetes services in the NHS published in 2012, estimated that a reduction of late referrals to specialist foot teams by up to 50%, could save the National Health Service at least £34 million a year by decreasing the number of major amputations among people with diabetes.
	The College of Podiatry has recently produced a briefing paper entitled The importance of podiatry to better health outcomes. They estimate that the cost to the NHS of poor foot care management is in excess of £1 billion.
	The latest published National Diabetes Audit report shows that over 85% of all those with diabetes in England and Wales received a foot examination in 2011-12, as recommended by National Institute for Health and Care Excellence Guidelines for Diabetes in adults.
	Within NHS England the National Clinical Director for Rehabilitation and Recovering in the Community and the Chief Allied Health Professions Officer are leading work to improve adult rehabilitation services including collection and dissemination of best practice. Good rehabilitation services will enable the delivery of new local models of care that improve outcomes, such as improving/maintaining foot health, by putting the patient at the centre of their care, and a focus on their goals.

Dental Services

Lord Colwyn: To ask Her Majesty’s Government, for each region of England in each of the last five years, how many patients with (1) head and neck cancer, and (2) hypodontia, have received treatment with dental implants.
	To ask Her Majesty’s Government, for each region of England in each of the last five years, what has been the cost to the National Health Service of dental implants for patients with (1) head and neck cancer, and (2) hypodontia.

Earl Howe: The attached table provides a count of Finished Consultant Episodes (FCEs) by Strategic Health Authority from 2008-09 to 2012-13 for patients with a primary diagnosis of either head or neck cancer1 or anodontia2 with a main or secondary operative procedure of a dental implant.
	Information on the cost to the National Health Service of dental implants for patients with head or neck cancer or hypodontia is not available in the format requested. The most relevant information is shown in the following table and is from reference costs, which are the average unit cost to NHS trusts and NHS foundation trusts of providing defined services in a given financial year to NHS patients.
	These costs include dental implants and other similar procedures, but do not distinguish between procedures on patients with diagnoses of head or neck cancer or hypodontia.
	
		
			 Table: Estimated costs of dental implants and other clinically similar procedures 
			  Unit cost per finished consultant episode £ 
			 Intermediate Mouth or Throat Procedures 296 
		
	
	
		
			 Major Dental Procedures 649 
		
	
	1
	It is unlikely that a dental implant would be carried out on the same episode as another treatment for cancer, so the count for head and neck cancer is likely to be a substantial undercount. This is because the implant is unlikely to occur until the cancer treatment was completed. If this is the case, the cancer code would not be recorded on the episode where the dental implant took place.
	2
	The diagnosis of anodontia includes but is not exclusive to those diagnosed with hypodontia.
	This Answer included the following attachment: Dental Implants table (HL2878 Lord Colwyn Dental Implants 19112014 table.xlsx)

Diseases

Lord Turnberg: To ask Her Majesty’s Government how many medicines for the treatment of rare diseases have been selected for assessment by the “Commissioning through Evaluation” mechanism.

Earl Howe: The Commissioning through Evaluation programme was established by NHS England in 2013 as an innovative mechanism to capture further evaluative data to inform future clinical commissioning policy in areas that show significant promise, but with insufficient existing evidence of clinical and/or cost effectiveness to support routine National Health Service funding.
	Five schemes are already in progress (selective internal radiation therapy, selective dorsal rhizotomy, Mitraclip, left atrial appendage occlusion and patent foramen ovale). These initial schemes all cover procedures, rather than drug treatments, at this stage.
	NHS England will consider the potential for any further schemes as part of the wider resource prioritisation process in place.

Diseases

The Countess of Mar: To ask Her Majesty’s Government which organisations within the National Health Service or which represent members who provide services to the National Health Service are bound by the World Health Organisation’s International Classification of Diseases (ICD—10).

Earl Howe: The United Kingdom as a member state of the World Health Organization (WHO) is expected to comply with the WHO Nomenclature Regulations 1967 and is required to use the most current version of the International Classification of Diseases (ICD-10) for reporting cause of death and disease for compiling and publishing mortality and morbidity statistics. As such all providers of National Health Service funded care are required to submit ICD-10 codes for national reporting.

Faith Schools: Hackney

Lord Warner: To ask Her Majesty’s Government what action they will take to safeguard children from the Charedi community in Hackney currently studying in unregistered schools.

Lord Nash: Lead responsibility for the safeguarding of children living in Hackney rests with Hackney Council. We are working with the Council and other agencies in the area to ensure that the needs of children in unregistered schools are met, and that appropriate action is taken to regularise the position of these establishments.

Grammar Schools

Lord Storey: To ask Her Majesty’s Government what proportion of grammar schools have been granted dispensation from the Department for Education to arrange their admissions procedures in favour of disadvantaged pupils who are eligible for free school meals, in each of the last five years.

Lord Nash: All schools with academy status, including grammar schools which are academies, may give priority in their admissions arrangements to disadvantaged children (ie those eligible for the pupil premium). The freedom granted through the funding agreement, allows these grammar schools to lawfully implement oversubscription criteria prioritising disadvantaged children within their admission arrangements, should they wish to do so. It is for the individual grammar schools to decide whether or not to adopt this priority within their own oversubscription criteria. To date, we understand 32 grammar schools have prioritised disadvantaged children in their arrangements and a further 65 intend to consult on doing so.
	Maintained schools—including maintained grammars—can currently adopt this freedom if they are granted a Power to Innovate Order. However, we have revised the School Admissions Code to allow all state-funded schools to adopt a pupil premium priority, should they wish to do so. Subject to parliamentary approval the revised Code will come into force in December 2014.

Marriage

Baroness Whitaker: To ask Her Majesty’s Government when they will publish their legislative plans to allow humanist marriages now that the public consultation is closed.

Lord Faulks: The Government is carefully considering the analysis of the responses we have received and the implications for marriage law and practice if a change were to be made to legislation. We plan to publish the Government’s response to the review by 1 January 2015.

NHS England

Lord Turnberg: To ask Her Majesty’s Government whether they will ask NHS England to publish the membership of its Clinical Priorities Advisory Group, its Specialised Commissioning Oversight Group and its Directly Commissioned Services Committee.
	To ask Her Majesty’s Government what criteria are used by the Clinical Priorities Advisory Group, the Specialised Commissioning Oversight Group and the Directly Commissioned Services Committee in their assessment of medicines for the treatment of rare diseases.

Earl Howe: The membership by role of the Clinical Priorities Advisory Group (CPAG) and the Specialised Commissioning Oversight Group (SCOG) can be found in each group’s Terms of Reference which are published on NHS England’s website.
	The criteria used by the CPAG and the SCOG can also be found in each group’s Terms of Reference. For those policies that require a commissioning decision in year then CPAG will use the In Year Service Development policy.
	Copies of CPAGs Terms of Reference, SCOGs Terms of Reference and the In Year Service Development policy are attached.
	The Directly Commissioned Services Committee has now ceased to exist. NHS England has advised that the first meetings of the new Commissioning Committee and the Specialised Commissioning Committee are expected in January. Membership of these committees has not yet been finalised.
	This answer included the following attachments: In Year Service Development (Commissioning Policy INYear Service Developments.pdf); CPAG Terms of Reference (CPAG Terms of Reference FINAL.pdf); SCOG Terms of Reference (Specialised_Comm_oversight_group_T_of_Ref_.pdf).

Overseas Students

Lord Ashcroft: To ask Her Majesty’s Government what is their estimate of the export earnings which derive from foreign students attending United Kingdom universities.

Baroness Williams of Trafford: In the Government’s International Education Strategy, published in July 2013, the value of international higher education students to the UK was valued at £9.7bn. The international education strategy can be found at https://www.gov.uk/government/publications/international-education-strategy-global-growth-and-prosperity More recent data for the 2012/13 academic year is now available. Based on this, BIS estimates that UK exports attributable to international higher education students were £10.4bn.

Police Service of Northern Ireland

Lord Morrow: To ask Her Majesty’s Government what financial support is available for police officers in Northern Ireland who have had to leave their homes due to security issues, including receipt of death threats, and have been forced to incur debt as a result, through the Scheme for the Purchase of Evacuated Dwellings, negative equity or any other cost or loss through no fault of their own.

Lord Bates: This is a devolved matter and is the responsibility of the Northern Ireland Department of Justice and Northern Ireland Housing Executive.

Staffordshire and Stoke on Trent Partnership NHS Trust

Lord MacKenzie of Culkein: To ask Her Majesty’s Government what assessment they have made of the role of the Ambassador for Cultural Change at the Staffordshire and Stoke-on-Trent Partnership NHS Trust.
	To ask Her Majesty’s Government whether plans are in place to roll out the position of Ambassador for Cultural Change across the National Health Service in England.

Earl Howe: We welcome local innovations such as the role of the Ambassador for Cultural Change at the Staffordshire and Stoke-on-Trent Partnership NHS Trust, but we have not made a formal assessment.
	We do not have plans to roll out this position nationally. Local National Health Service organisations are responding to the challenges of the Francis Inquiry in a number of different ways, and we will continue to support them through mechanisms such as the patient safety collaboratives, and the work of organisations such as Health Education England and NHS England.

Supply Teachers

Lord Storey: To ask Her Majesty’s Government what steps they are taking to ensure that supply teachers receive the same pay and pensions as other teachers.

Lord Nash: Supply teachers employed directly by a maintained school or local authority must be paid, like other teachers employed by these institutions, in accordance with the statutory arrangements set out in the School Teachers’ Pay and Conditions Document. They are also automatically enrolled in the Teachers’ Pension Scheme and are eligible for the same pension benefits as other teachers. The arrangements for supply teachers employed by private agencies, including their pensions and rates of pay, are private commercial arrangements.

Surgery

Lord Colwyn: To ask Her Majesty’s Government how many patients have undergone orthognathic treatment in each region of England in each of the last five years.
	To ask Her Majesty’s Government, for each region of England in each of the last five years, what has been the cost to the National Health Service of orthognathic treatment.

Earl Howe: Due to a lack of specific procedural codes, it is not possible to identify the number of patients who have undergone orthognathic treatment or the cost of this treatment from the data held by the Health and Social Care information Centre or the Department.